title: Health disparities around the world: perspectives from the 2012 Principles and Practice of Cancer Prevention and Control course at the National Cancer Institute.
abstract: BACKGROUND
  The National Cancer Institute Principles and Practice of Cancer Prevention and Control course is a 4-week course encompassing a variety of cancer prevention and control topics that is open to attendees from medical, academic, government, and related institutions around the world. Themes related to the challenges health disparities present to cancer prevention efforts and potential solutions to these issues emerged from facilitated group discussions among the 2012 course participants.
  
  
  METHODS
  Small-group discussion sessions with participants (n = 85 from 33 different countries) and facilitators (n = 9) were held once per week throughout the 4-week course. Facilitators prepared open-ended questions related to course topics. Participants provided responses reflecting their opinions of topics on the basis of experiences in their countries. A thematic analysis was conducted to explore themes emerging from the discussion groups.
  
  
  RESULTS
  The varied influences of health disparities on cancer prevention efforts among > 30 countries represented prominent themes across discussion groups. Participants discussed the interplay of individual characteristics, including knowledge and culture, interpersonal relationships such as family structure and gender roles, community and organizational factors such as unequal access to health care and access to treatment, and national-level factors including policy and government structure.
  
  
  CONCLUSIONS
  The ideas and solutions presented here are from a geographically and professionally diverse group of individuals. The collective discussion highlighted the pervasiveness of health disparities across all areas represented by course participants and suggested that disparities are the largest impediment to achieving cancer prevention goals.
authors.affiliation: National Cancer Institute, Bethesda, MD; University of Utah; and Huntsman Cancer Institute, Salt Lake City, UT.
authors.forename: Neetu
authors.initials: N
authors.lastname: Chawla
authors.forename: Deanna L
authors.initials: DL
authors.lastname: Kepka
authors.forename: Brandy M
authors.initials: BM
authors.lastname: Heckman-Stoddard
authors.forename: Hisani N
authors.initials: HN
authors.lastname: Horne
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Felix
authors.forename: Patricia
authors.initials: P
authors.lastname: Luhn
authors.forename: Colleen
authors.initials: C
authors.lastname: Pelser
authors.forename: Jonathan
authors.initials: J
authors.lastname: Barkley
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Faupel-Badger
mesh_terms: D000328:Adult; D003469:Culture; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006291:Health Policy; D006297:Health Services Accessibility; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000517:prevention & control*; D011314:Preventive Health Services; D012959:Socioeconomic Factors; D014481:United States